The present invention relates to systems and methods for monitoring and training sustained attention of users.
Sustained attention is important because it is the foundation for being focused, effective and productive in nearly every cognitive process we use in everyday life (effective, productive); it is also a significant component of many cognitive clinical disorders (e.g. ADHD, autism, schizophrenia, depression, SAD, PTSD, TBI).
Continuous Performance Tests (CPTs) have proven useful as assessment tools in normal populations and for assessing the clinical disorders mentioned above. A major limitation has been in their ability to assess the suppression of distractors. Using behavioral tests, in which distractors are by definition irrelevant and not to be responded to, one can assess a person's ability to ignore distractors only indirectly—by detecting the rare instance when a person responds incorrectly to a distractor which is indicative of less attention to the target and/or less suppression of the distractor (although which is the cause is ambiguous). Consequently, the data includes a small quantity of rare errors. Poor distractor suppression can also be indirectly inferred by measuring differences in performance to a target as a function of the presence of distractors (e.g., when a target is preceded by a distractor versus when it is not preceded by a distractor). Therefore, CPT tests do not provide a direct measure of continuous suppression of distractors. The only way to obtain such a measure is with brain physiology measures.
In well-accepted models of attention and behavioral studies, it has been recognized that enhanced processing of targets and suppression of distractors are not simply opposite sides of the same attention coin. It has always been difficult to characterize the processing of distractors behaviorally because it must be accomplished indirectly (e.g., distractor disruption of performance to target; occasional errors, false alarms to non-targets; etc.). Using neurophysiological measures we can directly measure the processing of all distractors as well as target processing. We now know that attending and suppressing distractors are at least partially separable functions that are controlled in part by different brain regions. EEG and fMRI literature shows that deficits in attending vs. distractor suppression can be differentiated behaviorally and physiologically. Consequently, it makes sense that these processes can be differentiated within an individual and that they can contribute differentially to cognitive disorders. The important implication for the prescription of therapeutics is that therapeutics can be tailored to attention processes or distractor suppression processes, or both.
Two people can perform comparably with different configurations of brain processes. For example, one person may enhance target processing with little suppression of distractors, while the other person has little enhancement of target processing and strong suppression of competing distractor inputs. In both cases the target processing wins over the distractor processing and the result is a similar output measure (e.g., RT). However, the same training or therapeutic that addresses, for example, target processing would likely result in quite different changes in these people. Ideally, training would focus on attending for one person and ignoring (distractor suppression) for the other. We propose an assessment tool that characterizes both attending and ignoring will open the door to the development of new cognitive training and therapeutics that can emphasize these two related yet separable aspects of sustained attention.
Being able to continuously monitor performance and brain components of attending and ignoring opens the door for training/therapeutics that provides ongoing feedback during sustained attention tasks. This is essential to creating improved awareness of attention (meta-attention) and attentional control.
Consequently, it is apparent that an urgent need exists for the ability to determine an individual's “brain style”, often referred to as “executive function”, so that therapeutics can be applied that target one or the other aspect of attending/ignoring processes.